Thursday, April 16, 2015

Living with Malaria

Most days we don’t think about the danger of malaria, and in fact we went off our anti-malarials last year as it had been months since our last mosquito bite. You see, on the Ashesi Hill, mosquitoes are as rare as a quiet night in the village, and the side effects of the anti-malarial agents are sometimes troublesome. Ok for a few weeks, but for the long term, inadvisable. We didn’t think about malaria much until Suzanne came down with it on April Fools. No kidding.

[In the 1960’s Ghana “stamped” out malaria]

Malaria’s name comes from a time when they didn’t understand it’s cause. The Romans thought it came from Rome’s swamps, fumes that caused the illness and named it accordingly, the Italian mal'aria, meaning "bad air". It wasn’t until the 1880s that a French scientist noticed parasites in the blood of a patient suffering from malaria, and made the connection. Twenty-seven years later the Nobel committee awarded Charles Louis Alphonse Laveran its prize for the discovery of malaria’s cause: a parasite carried from an infected mammal to humans in the bite of a mosquito.

If You Think You're Too Small To Make A Difference,

You Haven't Spent A Night With A Mosquito.

-African Proverb

So this week, both of us went back to our anti-malarials, but the truth is, these agents won’t act as a true prophylaxis. They can’t prevent the initial malaria infection after an infected bite, but only kill the parasites after they mature and are released from the liver to make their way to the brain. These so called anti-malarials are more a suppressive therapy, killing them before they kill you.

[We tried one of those home test kits, but it said she didn’t have malaria…twice]

The average life span of a mosquito is 3-4 weeks, so I think the one that infected Suzanne is certainly dead. The thing is, we’re not sure when it bit her, or where she was. Malaria can have a fourteen day incubation period and two of the three weeks before she had been out of the country, and though Ghana is ranked 8th in Africa by number of malaria cases per 100,000, Berekuso has very few mosquitos. It must have been Accra. Between trips, Suzanne had been there for just two days, attending a quality assurance meeting, before going to South Africa for another meeting. The day after she arrived back in Ghana, she began not feeling well. On Palm Sunday we skipped church to go to the clinic. By Maundy Thursday we are back to re-check her. It was malaria.

[Suzanne at the Clinic for Holy Week]

Besides its deadly potential, the really scary thing about malaria is how debilitating it is, and how quickly it comes on. In fact, according to the national newspaper, 10% of Ghana’s GDP goes to malaria related expenses. One minute you’re feeling a bit off, and the next you have the chills, a mind splitting headache and feel lethargic. Suzanne didn’t so much have the chills--it is hard to imagine anyone having the chills in Ghana—but she was extremely tired, otherworldly tired, clammy, and her head was paining her. Thank God her symptoms presented here in Ghana and not South Africa. Our plan had been for me to join her, and we would spend the weekend exploring Cape Town. Those plans fell through, thank God. There is no place like home when you are sick.

[Suzanne today, checking work email from our couch]

Though Suzanne no longer has malaria (the doctor did a blood test several days ago to confirm), she is still extremely tired, and has no energy. It is now more than two weeks in, and she is yet to have two “good days” in a row, meaning feeling relatively lucid most of the day. Our friends tell us that the forwards-backwards recovery is typical of malaria. They say the effects are worse because it is her first time.

Malaria is a beast, and the anti-malarials have their own risks. After I had been there awhile and gotten malaria a few times (it got a little milder each time,) I started taking the local bitters for malaria. Officially they are a treatment, but an expat friend recommended taking a dose or two once a month as a prophylaxis. I don't think I got sick anymore once I started doing that.

Glad you were near good care, and that you were there to take care of her. Feel better, Suzanne!